Individual
VAHID ENTEZARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D. M.M.SC
Contact information
Practice address
501 S 54TH ST, PHILADELPHIA, PA 19143-1900
(215) 748-9822
Mailing address
1 W ELM ST STE 100, CONSHOHOCKEN, PA 19428-4108
(610) 567-6964
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD461913
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2012
Last updated
10/11/2017
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